Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99373 | TX |
NPI | 1114587854 |
---|---|
Provider Name | Amanda Renee Whatley |
First Address | Stephenville, TX 76401-2138 |
Second Address | Stephenville, TX 76401-1904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2019 |
Last Update Date | 04/01/2022 |